Jessy Krallum, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61044253 Issued in WA

Practice address

6240 Tacoma Mall Blvd Ste 101
Tacoma, WA 98409-6819

Phone

(253) 271-9720

Fax

(720) 598-0440

NPI assigned

Feb 12, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dispatchhealth Washington PCGroup PAC ID 2062765423, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessy.krallum.1@13869.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dispatchhealth Washington PC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1013490507
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Physical Therapist
  • Lakewood, WA
  • NPI 1790298081
  NPD
• Dispatchhealth Advanced Care - Washington PC

  • Hospitalist Physician
  • Denver, CO
  • NPI 1093324659
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1508498015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 TACOMA MALL BLVD STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096819",
            "telephone_number": "253-271-9720",
            "fax_number": "720-598-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 TACOMA MALL BLVD STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096819",
            "telephone_number": "253-271-9720",
            "fax_number": "720-598-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRALLUM",
        "first_name": "JESSY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2021-04-09",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202001367NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61044253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Koznarsky, M.D.
• KR Sammy BD Pak DDS PLLC
• Stacie Linne Krabill, ARNP
• Kelly A Kraemer, BA , SUDPT
• David William Kraljevich, LMHC
• Gregory Kramer, PHD
• Pamela Kramer
• Stephen G Kramp, MD
• Sarah Matteson Kranick, MD
• Marian Kranz

• Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.